Includes the consultation within the same appointment and the result of the semen test by mail Price varies according to location and technique

Vasectomy no scalpel and no needle, in one appointment

A vasectomy is a simple surgery done by Dr Marois in all four clinics. The small tubes in the scrotum (vas deferens) that carry sperm, are cut or blocked off so sperm can’t leave the body and cause pregnancy. The procedure is very quick, and the patient can go home the same day.

There are two types of vasectomies: the incision method  and the no-scalpel-no-cut method. No-cut methods lower the risk of infection and other complications, and generally take less time to heal; this is the option that Dr Marois has to offer.

Vasectomies are meant to be permanent — so they usually can’t be reversed. Patients should therefore only get a vasectomy if they are 100% positive they don’t wish to be fertile anymore.

Dr Marois initially conducts a thorough evaluation before performing any vasectomy; this involves a short questionnaire, a physical exam and an explanation of the procedure.

After this, it is possible to proceed with the vasectomy (a single visit) if the patient wishes to. This is conditional on a normal exam and if any anticoagulant medication has been stopped prior. On the other hand, if a patients not sure about the surgery, a second appointment can be given for a later date.

Dr Marois recommends that the patient comes accompanied. If needed, an Ativan may be offered only to patients who are anxious. It is also recommended that the patients avoid coffee or other stimulants on the morning of the vasectomy.

Please note that vasectomies are only performed in a disaffiliated private clinic and therefore not covered by the RAMQ. They are usually carried out in a single appointment. This includes consultation and infertility notification by email after reception of the spermogram’s results.

How is a vasectomy performed?
After your assessment, you will be lying on a table in a minor surgery room. Dr Marois will begin with a proper anesthesia using a needle-free pressure injector (MADAJET) of the scrotal skin, below the level of the junction of the scrotum and the penis. We usually wait 5 to 10 minutes to allow an optimal anaesthesia and we take advantage of that time to disinfect the region.

Dr Marois will grasped the left vas deferens with a Chinese round clamp and proceed with a millimetric orifice with a Chinese pointed forceps. The tube will then pulled to be sectioned, each end will be cauterized and ligated with a soluble suture. Dr Marois does not use or leave permanent metal clips to clamp the vas, as that may create chronic pain.

Moreover, in order to further minimize the risk of spontaneous re-canalization, Dr Marois will conduct a better isolation of the deferent canal on the abdominal side by interposing the spermatic fascia. This less common method takes a few minutes of extra work per vas (right and left). It is essential to cover the vas deferens with a layer of tissue that surrounds each channel.
Is vasectomy is a permanent male contraceptive method?
In principle, the technique is irreversible. If ever the patient wishes to have children after the intervention, we can attempt a vasovasostomy, with no guarantee of success.
Are there possible complications?
Complications are uncommon, but it is possible to have bleeding, infection, swelling or pain in the scrotal area. If there is persistent inflammation or discomfort, an anti-inflammatory drug may be prescribed.

Very rarely, the vas deferens canal will reform on its own before the control spermogram (early recanalisation: the two ends of the vas deferens canal reattach and allow for the passage of spermatozoa, making the man fertile). Exceptionally, spontaneous late recanalisation after vasectomy can occur, even with sectioning, ligation and cauterisation of the vas deferens.
Are there any medical contraindications?
These are relative and rare. Uncertainty about whether or not you may want children, blood coagulation disorders, scrotal hernia and non-descended testicles are some examples. In certain patients, vasectomy is sometimes unilateral and thus only performed on one side.
Does the vasectomy impacts sexuality?
Your sexuality remains unchanged. Erections and ejaculations are unchanged. The liquid from ejaculation will no longer contain spermatozoa, but you will not be able to see any difference in the ejaculate since spermatozoa represent only a small part of this liquid. You will also experience no change as regards to sensation and orgasm.
Is anesthesia painful?
This procedure is initially done with an injector which sends anesthetic liquid through the skin at high pressure. You will feel a pinching sensation like being struck with an elastic band. After that, you will no longer feel the needle in the skin or sub-cutaneous tissue at the scrotal site.

However, anesthesia is limited to the area around the injection site.

For more effective anesthesia and a more comfortable vasectomy, a right and left spermatic block is performed. This is an infiltration of the spermatic cord that eliminates pain inside the scrotum.

In addition, the sometimes unpleasant abdominal traction of the vas deferens can be slightly felt. We need to wait 5 to 10 minutes before starting the intervention. There is a small risk of hematoma since the needle is manually steered alongside the visible veins.

An Ativan is offered to anxious patients before the vasectomy, if they are accompanied.
Can my partner be present during my vasectomy?
The partner who accompanies you may be present with you in the surgery room for moral support. A protective screen is placed on the thorax which prevents to see the intervention.

Request an Appointment

Dr. Marois is a urologist who is not a member of the Régie d’Assurance Maladie du Québec (RAMQ). As such, the clinic can not claim the RAMQ for the payment of his services. If you consult Dr Marois, you must pay for the services rendered.

Cancellation of appointment:

To ensure the smooth running of the clinic and a minimum of courtesy towards other patients and our staff, we ask you to notify us 48 hours in advance for the cancellation of a consultation, 5 working days in advance for a surgery at the office and 21 working days in advance for a major surgery. If these deadlines are not respected, a cancellation fee of 50% of the service will be charged.

Change of appointment:

We understand that events occur, so we ask you to provide us with at least a 24-hour notice for any change in their appointment; we will be happy to accommodate you, the best we can. However, if you fail to inform us within this timeframe or do not show up, we will charge a $ 100 fee.

Thank you for your understanding.

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